ID~ 1410M CRM-001 04/12/88 Ankle ~upport Apparatus Bac~arv~nd This invention relates to ankle support apparatus and to footwear incorporating ankle support structures. In particular, it provides ankle support apparatus for use in protecting against injury and for use during recovery from an ankle injury. The support apparatus is particularly useful with regard to sprains of the lateral ligaments of the ankle 10 This type of injury commonly occurs from undue inversion of the ankle.
The invention provides ankle support apparatus that can be a separate device, e.g. for wearing without conventional footwear and, alternatively, inside footwear, and that can be incorporated in footwear.
Sprains of the lateral ankle ligaments are a common injury to humans. Protection from such injuries have included taping and bracing. Surgical 20 operation~ are a~ailable to repair sprained ligaments directly, and other operations are available to reconstruct sprains. Many surs~ical operations endeavor to enhance the ligament strength in the ankle on the outer, lateral side. Such operations can provide a stable ankle, good performance for sports, and low discomfort. However, they often significantly reduce passive inversion of the ankle.
The prior art regarding devices for bracing the ankle against lateral sprains is relatively 30 extensive, and includes the followin~ United States Patents Numbers 1,129,525 of Severy; 1,397,095 of Hamilton; 4,323,058 of Detty; 4,440,158 of Shapiro;
4,523,394 of Lindh et al; 4,527,556 of Nelson;
~,547,981 of Thais et al, 4,556,054 of Paulseth; and 4,651,726 of Holland.
-2- 1319058 An object of this invention is to provide readily removable and replaceable ankle support apparatus that provides secure bracing against lateral inversion. Another object is to provide such ankle support apparatus that provides reliable inversion support.
Further objects of the invention include the provision of ankle support apparatus of the abov~
character that is convenient to use, light in weight, 10 has small bulk, and is hence unobtrusive and which is convenient and comortable for the wearer. It is also an object that the support apparatus b~ suitable for low cost manufacture.
Another object is to provide ankle support apparatus of the above character that is suited for use separate from footwear and that, alternatively, can be incorporated into footwear.
Other objects of the invention will in part be obvious and will in part appear hereinafter.
20 General nescription An ankle support device according to the invention has a bracing pad that seats on the lateral side against the heel bone or os calcis. The bracing pad also seats against the underside of the lateral malleolus. The bracing pad is configured anatomically to supportingly engage both laterally against the os calcis and upwardly against the lateral malleolus. The support device carries the bracing pad to bear laterally against the os calcis 30 and to bear upward on the lateral malleolus when the ankle inverts, in a manner that resists undue inversion and thereby prevents injury and provides support during healing.
According to one practice of the invention, the structure of the support device which carries and deploys the bracing pad includes a vertically e~tending lateral stirrup strap, on which the bracing pad is carried. The stirrup strap is secured at an upper end to an ankle encircling strap or ankla wrap. The ankle wrap preferably has a cuff that 10 encircles the ankle seated on the lateral malleolus, and preferably on both th~ malleoli, and resists downward movement on the ankle even when the strap is tensioned.
A further preferred practice of the invention employs an ankle wrap having a cuff that is flared, with a smaller top circumference, in conformance with the upper con:ical flare of the upper portions of the malleoli. Additional features of the ankle cuff according to the invention are an 20 asymmetrical cross section in a horizontal plane, with a long and hence major front-to-back, i.e.
longitudinal, a~is and a lesser, i.e. minor, side-to-side or transverse a~is. The cuff, which has significant stiffness, ha~ relatively short height at the back, providing some reliaf of pressure at the Achilles tendon, and considerably greater height on both sides, to overlap the malleoli. These structural features, combined with a circumference-adjusting strap, enable the ankle cuff 30 to seat yet comfortably above the ankle joint and to resist sliding downward, which would undesirably slacken either or both elevator straps. Further, the structural features of the ankle cuff hold it -4- 131905~
reliably in place rotation-wise, i.e. it resists twisting on the ankle. Instead the cuf enables the wrap to provide secure reliable anchorage for the upper end of the elevator strap system.
One practice of the invention further provides a heel cup to which the lower end of the stirrup strap is attached. The heel cup extends under the heel of the wearer towards the metatarsal base and preferably wraps around the sides and back 10 f the heel with a structure which mo~es with heel, e.g. that resists slippage relative to the heel, when the heel inverts.
A medial stirrup strap extending between the ankle wrap and a heel cup is a preferre~ optional practice for enhancing support and stability of the support device. The medial strap preferably has negligible slack during normal ankle posture and hence t~nsions under eversion.
One preferred anatomical configuration of 20 the bracing pad employs a broadl, spade-like wedging contour. This feature of the invention endows the bracing pad with relatively small height and considerably greater lateral length. A two-to-one aspect ratio of length to height is typical for one preferred practice. The lower contour of the pad in this embodiment is concavely rounded and the upper contour is substantially flat or slightly conve~ to receive and accommodate the lower rim of the lateral malleolus. The size of the pad preferably conforms 30 generally to the lateral surface of the os calcis, to enhance seating below the lower rim of the lateral malleolus.
The thickness of the bracing pad preferably also is contoured. One embodiment has a substantially uniform ma~imal thickness along an upper third portion combined with diminishing thickness, and hence an outward taper, to the lower peripheral rim.
According to further features of the invention, an article of footwear carries a bracing pad on the lateral side bearing against the os calcis 10 and the underside of the lateral malleolus. The footwear article can include a lateral stirrup strap for carrying the bracing pad at an adjustable elevation for maximal support and comort. An ankle encircling adjustable strap on the footwear, above the malleoli, can anchor the upper end of this stirrup strap element for secure and reliable deployment of the bracing pad.
The footwear can employ a bracing pad deployed on a stirrup strap element or other 20 structure in this manner either internal of the normal footwear shell or externally.
The further structure of the footwear article which supports and encloses the heel of the wearer can provide anchorage for the lower end o~ the stirrup strap element, e.g~ can serve as the heel cup as described above.
These and further features of ankle support devices according to the invention as described and illustrated herein provide a high level of ankle 30 support, particularly against undue lateral inversion. The support devices can also provide support against undue eversion. Ankle support structures according to the invention provide a high -6- 1 3t9058 degree of user comfort and convenience, in addition to both protection against injury and support bracing during recovery from lateral ~train and other ankle injuries.
Brief DescriptiQn of Drawinys The invention accordin~ly comprises the features of construction, combinations of elements and arrangements of parts e~emplified in the constructions hereinafter set forth and in the 10 article described, and the scope of the invention is indicated in the claims. For a fuller understanding of the nature and objects of the invention~ reference is to made to the following detailed description and the accompanying drawings in which:
FIGURE 1 is a diagrammatic perspective view of an ankle support device according to the invention;
FIGURE 2 is a similar view of another ankle support device according to the invention;
FIGUR~ 3 shows one preferred embodiment of 20 an ankle support according to the invention fitted onto a wearer;
FIGURES 4 and 5 are detail views of the bracing pad of the support device of FIGURE 3;
FIGURES 6 and 7 further illustrate the ankle wrap and cuff of the support device of FIGURE 3;
FI~URE 8 further illustrates the heel cup of the support device of FIGURE 3;
FIGURES 9 and 10 are showings, from the back, of the support device of FIGURE 3 under 30conditions of normal posture and lateral inversion, respectively;
1 3 1 905~
FIGURES 11 and 12 are front views corresponding to the rear views of FIGURES 9 and 10 and showing respectively normal posture and lateral inversion;
FIGURES 13 and 14 shows articles of footwear incorporating ankle support structures in accordance with the invention; and FIGURES 15 and 16 show embodiments that include dorsiflexion assisting elements according to the invention.
Description of Illustrated Embodiments An ankle support device 10 according to the invention has, as FIGURE 1 shows for a left ankle, a bracing pad 12 that seats on the lateral side of a wearer, against the heel bone or os calcis and against the underside of the lateral malleolus. An ankle cuff 14 of the device encircles the leg of the wearer seated on the upper side of the lateral and medial malleoli.
A stirrup element 16 connects at the top upper ends of lateral and medial branches 16a and 16b respectively of its U-shaped configuration to the latexal and medial sides of the ankle cuff 14. The span of the stirrup element between the branches passes under the wearer's heel at a location substantially below the malleoli. The stirrup branches thus e~tends substantially vertically, in normal disposition, along the lateral and medial sides of the wearer's ankle. The stirrup element 16 30 carries the bracing pad 12 on the lateral branch 16a.
131qO58 The stirrup branches resist tensile elongation and can otherwise be flexible and compliant.
The ankle cuff 14 is conically flared and otherwise contoured to seat substantially fixedly on the upper si.des of the malleoli. It resists movement vertically, i.e. up and down on the wearer, and resists rotation, i.e. twisting about the ankle of the wearer.
The ankle support device 10 imposes minimal impediment or restriction to normal fle~ure of a wearer~s ankle about a horizontal side-to-side, i.e.
transverse, a~is 18. This is the motion normally involved in walking, and includes e~tending the foot to point the toes and retracting the foot to raise the toes. During this walking-type flexure, the elements of the support device 10 remain essentially in place on the wearer and the stirrup branches flex to accommodate the wearer's movement.
The ankle support device 10 however resists lateral inversion of the wearer~s ankle. This is 1e~ure of the foot about a normally horizontal front-to-back, i.e. longitudinal, a~is 20~ Both a~es 18 and 20 interact the ankle joint, at the malleoli, as shown. I~ particular, the tensile strength o~ the lateral stirrup branch 16a resists lateral inversion. The tensile strength resistance of this stirrup branch, which becomes increasingly taut with increasingly lateral inversion, thus acts similar to 30 lateral ligaments of the wearer's ankle and thereby reinforces and aids the lateral ligaments in resisting the lateral inversion motion.
-9- 131qO58 The ankle support device 10 additionally resists lateral inversion by the action of the bracing pad 12 laterally inward against the os calcis and upward against the lateral malleolus. These bracing forces result from lateral inward and upward urging which the tensioned stirrup lateral branch 16a imparts to the bracing pad which the branch carries.
FIGURE 2 shows an ankle support device 2~
according to the invention and generally similar to 10 the device 10 of FIGURE 1 with an ankle cuff 24 and a lateral hracing pad 26. A heel cup 28 of the device seats under the heel of the wearer and has sides that partially encircle the sides and back of the heel to move with the heel of the wearer. A lateral stirrup strap 30 is connected at its upper end to the ankle cuff 24 and at a lower end to tha heel cup 28. The strap carries the bracing pad 26 disposed along lateral side the os calcis of the wearer and the underside of the lateral malleolus.
The ankle support device 22 of FIGURE 2 operates similar to the device 10 of FIGURE 1, in that upon lateral inversion of the wearer's ankle, the lateral strap 30 becomes increasingly taut~ This tension of the strap, secured between the substantially fixed ankle cuff 24 and the heel cup 28 that moves closely with the heel of the wearer, resists the lateral inversion motion. The tensioned lateral strap also increasingly urges the bracing pad 26 laterally against the os calcis and upwardly -30 against the lateral malleolus to enhance the resistance to lateral inversion.
FIGURE 2 indicates with dashed lines that the ankle support brace 22 can employ, as an optional -lo- I319058 element, a medial stirrup strap 32, where desired for added stability and to support against medial inversion of the wearer's ankle.
An ankle support device 34 shown in FIGUR~ 3, and in detailed views of FIGURES 4-~, employs a bracing pad 36 carried on a lateral strap 40 that spans between an ankle wrap 42 and a heel cup 44. The illustrated support device 34 includes an optional medial strap 46 that spans between the 10 medial sides of the cuff 42 and the cup 44, substantially parallel to the lateral strap 40.
The bracing pad 36 FIGURES 4 and 5 has an inner bearing surface 36a contoured to the anatomically rounded recess on the lateral side of a foot against the heel bone and the lateral malleolus. The pad 36 is substantially non-yielding, i.e., is substantially rigid or stiffly resilient and has a relatively la~ge bearing surface, typically for contacting the wearer along a distance greater than 20 the front-to-back, lateral span of the lateral malleolus. The peripheral contour of the illustrated bearing surface 36a has an upper rim 36c that is slightly convex to receive and fit around the rounded malleolus, and has a side and lower rim 36d that is substantially continuously concavely rounded. This overall contour is roughly similar to that of a short, broad tool blade, as on a shovel. The bracing pad hackwall 36b is straight as viewed in a vertical plane, as in FIGURE 5, and is curved as viewed in a 30 horizontal plane. The inner bearing surface 36a is similarly curved in a horizontal plane and is concave as viewed in a vertical plane, with substantial thickness in an upper portion and diminished -11- 1 3 1 qO58 thickness below. The bracing pad hence has a plano-concave wedge-like cross-section, as appears in FIGURE 5.
One typical construction for the illustrated bracing pad 36 employs a stiff panel 48 of synthetic polymer that forms the back wall 36b and which carries a firm cushion material such as a closed cell synthetic foam 50 that forms the inner wall 36a. A
strap-engaging loop 52 on the panel 48 projects 10outwardly from the backwall 36b for slideably receiving, with selectively adjustably interference, the lateral strap 40, as appears in FIGURE 4. One embodiment of the pad 36 is made of an espanded polyethylene with a hard, dense durometer as the foam element 50, backed by a 0.062 inch thick polypropylene shell as the panel 4B. The shell is cut to form the loop 52.
With reference to FIGURES 3, 6, and 7~ the illustrated ankle wrap 42 has a stiffly compliant 20 open cuff 54 that seats around the sides and back of a wearer's leg at the upper out:ward flare of the malleoli. The cuff 54 thus encircles the sides and back of a wearer's leg. An adjustable strap 56 which the cuff carries, spans across the front opening of the cuff, as FIGURE 6 shows. The illustrated cuff 54 has a generally straight and normally horizontal upper rim and a saddle-shaped lower rim that forms relatively long side panels 54a and 54b, that seat over the malleoli, and a relatively short panel 54c 30 that crosses the Achilles of the wearer.
The cuff of the wrap 42 further conforms anatomically to the substantially elliptical shape of a wearer~s leg and hence has a generally elliptical horizontal cross-section with a longitudinal axis longer than the transverse axis, as appears in FIGURE 7. Further, the cuff side panels 54a and 54b flare conically outward, to give the cuff a smaller circumerence at the top and downward-facing outward conical flare, to conform anatomically to the outward flare of a human ankle at the upper portion of the malleoli.
The ankle wrap 42 can be fabricated in the 10foregoing manner with a cuff 54 of formed synthetic resin sheet or panel stock lined for added comfort with a layer of synthetic resin foam. The cuff is secured by integral loops, as illustrated, to a pliable tensile strap 56 fitted with rings and adjustable hook and loop or like fasteners. One preferred embodiment of the wrap 42 is made with an outer sh~ll of 0.062 inch polypropylene with an inner liner of e~panded polyethylene of medium density durometer.
With the foregoing structure, the ankle wrap 42 seats securely yet comfortably on a wearer and is anatomically keyed to the contour of the wearer to resist both rotation or twisting around the wearer and vertical movement along the wearer. The ankle wrap 42 thereby provides a substantially fixed upper anchorage for whatever stirrup straps are employad in the support device and particularly for carrying and deploying the bracing pad.
The illustrated heel cup 44, shown in 30 FIGURES 3 and 8 receives and anatomically seats on the heel of the wearer, to move with the heel. Thus, during foot and ankle motion, particularly during lateral and medial inversion, the wearer s heel e~periences minimal sliding within the heel cup.
Instead, the heel cup moves with the heel of the wearer. The illustrated heel cup structure includes a sole panel 44a that extends under the sole of the wearer, forward from the heel to the back of the instep, and a side wall 44b that wraps around the soft bulbous sides of a wearer's heel. The heel cup 44 can, by way of e~ample, be formed of a thin sheet of synthetic polymer.
The lateral strap 40, FIGURE 3, is secured to the strap 56 of the ankle wrap 42, threads through the loop 52 on the bracing pad 36 and is secured at its lower end to the lateral sidewall of the heel cup 44. The strap 40 is adjustable in length and carries fastening elements, typically of the hook and loop type, to resist tensile elongation. The medial strap 46, when provided, i5 similarly secured at opposite ends to the ankle wrap 42 and to the medial sidewall of the heel cup 44, and is arranged to be adjustable 20 and to resist tensile elonqation. ~oth straps 40 and 46 preferably are otherwise pliable and compliant for user comfort.
The operation and functioning of the support device 34 as thus arranged and constructed is similar to that described above with reference to the support devices 10 and 22 of FIGURES 1 and 2, respectively.
More particularly, FIGURES 9 and 11 show respectively back and front views of the support device 34 on a wearer during normal upright, e.g.
30 standing, posture. The ankle wrap 42 encircles the ankle of the wearer with a secure and comfortable fit and is seated on the upper surfaces of the malleoli.
The two stirrup straps 40 and 46 have minimal slack.
-14- 1 31 q 0 58 The bracing pad 36 is disposed softly against the ankle bone and the underside of the lateral malleolus.
Upon lateral inversion of the wearer's ankle, as appears in FIGURES 10 and 12, the heel cup 44 rolls with the heel of the wearer, and the ankle wrap remains securely in position on the wearer. The resultant increased tension of the lateral strap 40 resists the inversion motion due to the tensile strength of the strap. Moreover, the increased lOtension of the strap combined with the lateral inversion of the ankle joint against it increasingly bears the bracing pad 36 inwardly and upwardly against the wearer, to additionally brace the ankle joint against further inversion motion.
Alternative to the support devices of FIGURES 1-12 that are separate from footwear, ankle support bracing in accordance with the invention can be incorporated into footwear. In particular, FIGURE 13 shows a shoe 60 of generally conventional 20construction with an ankle-height cuff 62 and fitted with ankle supporting brace elements in accordance with the invention. The illust:rated shoe 60 has an upper that extends, as in a high sneaker and common work shoe, to above the ankle joint. The shoe carries an ankle strap 64 that wraps around the wearer's leg at the upper slopes of the malleoli and can be secured upon adjustment. An adjustable lateral stirrup-like strap 66 is secured to the lateral side of the shoe by an upper end connection 30 to the ankle strap 62 and by a lower end connection to the shoe structure. A lateral bracing pad 68 is carried on the lat~ral strap to bear against the os calcis and the lateral malleoli of the wearer. In the illustrated shoe 60, the bracing pad is disposed outside the wall of the shoe. The invention can similarly be practiced with a bracing pad supposed within the wall of a shoe to bear directly against the wearer.
FIGURE 14 shows another shoe 70 according to the invention with an ankle strap 72 incorporated at the upper rim of the shoe cuff. The shoe 70 includes a heel cup 74, shown partly with solid lines and partly with ~roken lines, that provides secure seating for the heel of the wearer and to which the lateral strap 72 preferably is secured at its lower end. This structure of the shoe 70 provides secure support and deployment for a bracing element 76.
~ nkle support structures, including footwear, as described and as illustrated in FIGURES
1 through 14, can include an optional elastic strap element tensioned from the ankle cuff to urge dorsifle~ion o the foot, i.e., lifting of the ball of the foot and the toes. This movement, which is opposite to the movement commonly termed pointing one's toes, is involved in generally all foot motion and movement. The provision o a dorsifle~ion strap in accordance with the invention, ~s detailed below, is deemed advantageous with certain muscle weaknesses and in activities involving strenuous oot movement, as encountered for example by athle.tes.
FIGVRE 15 shows ankle support apparatus 80 similar to that described with reference to FIGURE 1 and further having a dorsiflexion strap in the form of a stirrup-like strap element 82 arranged to span from the sides of an ankle cuff 84 to underneath the arch of the wearer's foot. The illustrated dorsiflexion element employs an elastic strap 86 and includes a length-adjusting buckle 88. The two ends are secured to opposite sides 84a and 84b of the ankle cuff. The illustrated strap element 82 is affi~ed to the ankle cuff 84 to extend diagonally, i.e. at an angle from the vertical, to position the base 82a of the stirrup configuration under the arch of the wearer. The support apparatus 80 further has a lateral stirrup element 90 and a bracing pad 92 10similar to the corresponding elements of the brace 10 of FI~URE 1.
The stirrup-like dorsifle~ion strap element 82 can be formed entirely of elastic, aside from the buckle 88. One alternative is to employ a combination of one or more elastic elements, typically one in each arm of the stirrup configuration, and inelastic elements, such as an inelastic arch section, under tha sole of the wearer's foot.
An ankle support device 92 with a dorsiflexion element according to the invention and having a heel cup 96, as appears in FIGURE 16, has an ankle cuff 98 and a lateral bracing pad 100 and a lateral stirrup strap 102, all similar to corresponding elements of th~ ankle support device of FIGURE 2. The FIGURE 16 embodiment may also have a medial stirrup strap 104, as indicated with broken lines.
The illustrated dorsiflexion element of the 30 device 94 includes a frontal e~tension 96a of the heel cup, which e~tends anteriorally under the arch of the wearer, and has at least one dorsifle~ion strap 106 connected between the lateral side of the -17- 1 3 1 9 05~
ankle cuff 98 and the lateral side of the forward e~tension 96a of the heel cup. For balance and symmetry in operation, a preferred construction employs a medial dorsiflexion strap 108 similarly connected on the medial side of the support device 94, as shown with broken lines. The dorsiflexion strap 106, which extends diagonally between the ankle cufE and the heel cup and includes a length and tensioning adjustment buckle as illustrated, has sufficient elasticity to remain under tension throughout a full excursion of movPment of the ball of the foot. Note that the dorsifle~ion strap elements 82 in the embodiment FIGURE 15, and 106 and 108 in the embodiment FIGU~E 16, can be structured to be readily removable and yet replaceable so that the user can enjoy the ankle support devices 80 and 94, respectively, with or without the dorsiflexion elements.
Dorsiflexion assisting structures as 20 provided by the invention can also be employed in footwear, such as the shoes 60 and 70 of FIGURES 13 and 14, respectively. The shoe 60 has an optional dorsifle~ion element, shown with broken lines, that employs an elastic cord 110 spanning adjacent one lace eyelet and tensioned between the ankle cuff 62 of the shoe and a frontal surface 112 of the shoe vamp, as shown. The illustrated cord 110 is secured by heavy stitching at its ends llOa and llOb.
Ey~lets 114 affixed to the shoe typically are 30 employed to guide and support the dorsifle~ion cord 110. A dorsiflexion cord 110 as illustrated in FIGURE 13 can b~ provided on either one or both sides -18- 1 3 1 qO5~
of a shoe, i.e. a shoe can be provided with either or hoth a lateral and a medial dorsiflexion element.
FIGURE 14 similarly shows a dorsifle~ion assisting elastic cord 118 incorporated in the structure of the shoe 70. The cord 118, the ends of which are secured respectively to the shoe at the ankle cuff and on a forward location 120 on the shoe vamp, is illustrated as positioned by eyelets 122, along an eyelet flap 124. As in the shoe 60 of 10 FIGURE 13, the shoe 70 of FIGURE 14 can employ either a single such dorsiflexion assisting cord 118 and alternatively can employ two such cords, one on either eyelet flap 124 and 126, or similarly arranged on either side of the lace opening or other frontal structure of the shoe.
Dorsiflexion assisting structures as described with reference to FIGURES 13-16, in one illustrative instance, extend from close to the base of the fifth metatarsal and run superiorly and 20obliquely to a further point of attachment on the side of the ankle cuff. In footwear, the dorsiflexion structure can be incorporated within the structure and not be visible, and alternatively can be outwardly apparent to enhance the distinctive appearance of the footwear. In each instance~ it is understood that a dorsiflexion assisting strap assists in preventing inversion of the ankle, and enhances a competitor's walking, running and other foot movements, particularly when tired or to 30overco~e weak or injured conditions. A medially arranged dorsiflexion assisting strap is understood to assist the anterior tibial muscle, whereas a strap arranged on the lateral side is understood to be of value under conditions of weak ankles, recurrent tendency to sprain, and recovery from a sprain.
It will thus be seen that the ob~ects set forth above, among those made apparent from the preceding description, are efficiently attained with an ankle support and with shoe structures as shown and described. It is to be understood that all matter contained in the above description and shown in the drawings is within the scope of the claims 10 appended hereto.
Having described the invention, what is claimed as new and secured by Letters Patent is: